2010年--2012年深圳市食品卫生安全检测结果分析

目的：分析深圳市2010年-2012年主要食品类别（如肉类、蔬菜类、水果类等）中微生物、重金属、添加剂超标情况的变化趋势，并通过数据分析了与食品卫生安全相关的三个因素：食品产地、检测地点和检测季节，从而提出更加科学的食品抽检方案，提高抽检效率。方法：数据来源于深圳市市场监督管理局网站2010年-2012年的食品检测信息，首先运用层次分析法并通过 MATLAB 编程得出微生物、重金属和添加剂在食品卫生安全综合评价中的权重，计算出综合评价指数。其次根据深圳市食品安检局标准处推荐的评价标准（GB3838-2002《食品安检质量标准》以及《食品质量分级》）得出2010年-2012年深圳市食品卫生安全的等级情况。然后运用 SPSS 针对食品卫生安全分别与食品产地、检测地点和检测季节进行回归分析并得出他们之间的关系。最后，根据以上结果制订出食品抽检优化方案，使之更科学有效地反映食品卫生安全状况。结果：通过分析可以看出，虽然深圳市2010年-2012年食品卫生安全等级均为Ⅱ级，但是食品卫生安全系数分别为0.224，0.157，0.122，根据此系数值越小安全等级越高，可见这三年的食品卫生安全情况在逐年提高。另外，经回归分析可得出食品卫生安全分别与食品产地、检测地点和检测季节这三个因素的线性关系，分别是：食品安全检测的不合格率=2.353＋0.003×食品产地距深圳市的距离；食品安全检测的不合格率=2.230＋0.024×检测地点与深圳市中心距离；食品安全检测的不合格率=4.545-1.131×检测季节。结论：2010年-2012年深圳市食品卫生安全情况在逐年改善；食品安全监测的不合格率与食品产地、检测地点和检测季节均有相应的线性关系；在监管成本有限、检测时间一定的情况下，应对检测次数进行合理分配以优化食品检测方案。即对于检测结果稳定或检测情况较好的食品种类减少检测次数，对检测结果不稳定或检测情况较差的食品种类增加检测次数，此方法可在一定程度上提高食品卫生安全的检测效率。     

OPT-CAD评分对行直接PCI术后急性心肌梗死患者缺血事件风险的预测研究

目的 评价中国冠状动脉疾病患者的最佳抗血小板治疗（OPT-CAD）评分对接受直接经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者出院后12个月缺血事件风险的预测价值。方法 选取2016年3月—2019年3月由中国人民解放军北部战区总医院心血管内科收治的1 953例AMI行直接PCI患者为研究对象。根据OPT-CAD评分进行分组,将患者分为低风险组（OPT-CAD评分<90分）541例和中高风险组（OPT-CAD评分≥90分）1 412例。所观察的主要结局事件是出院后12个月内的缺血事件,包括心源性死亡、心肌梗死及卒中。次要结局事件为12个月内缺血事件的各独立组成成分及全因死亡。绘制受试者工作特征（ROC）曲线,评价OPT-CAD评分对患者院后12个月内（出院后3、6、9、12个月）缺血事件的预测价值。结果 与低风险组患者比较,中高风险组患者12个月的缺血事件、心源性死亡及全因死亡发生率显著增加（P <0.05）。OPT-CAD评分预测患者出院后3、6、9、12个月缺血事件的曲线下面积（AUC）分别为0.767(95%CI:0.701,0.832)、0.769(95...     

Systemic sclerosis associated myopathy

SummaryScleroderma associated myopathy (SScAM) is a common but heterogeneous musculoskeletal manifestation of systemic sclerosis (SSc) for which there is still no clear definition. Still, SScAM is associated with disability, poor quality of life and mortality. This review discusses the most updated literature of SScAM including clinical and antibody associations, recent updates on histopathological findings, prognosis and treatment.     

Posterior reversible encephalopathy syndrome and autoimmunity

Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome characterized by acute or subacute onset of neurological symptoms (e.g., headache, seizure, confusion, vomiting, and diminished eyesight) and impaired endothelial barrier function of the cerebral circulation that leads to bilateral subcortical vasogenic edema, while exhibiting a “reversible” feature in most cases. Clinically, various predisposing or precipitating conditions have been identified, such as hypertension, autoimmune diseases, renal dysfunction/failure, preeclampsia/eclampsia, post-transplantation conditions, and certain therapeutic agents. Among several putative mechanisms, the immune activation hypothesis prevails, as up to 50% of patients with PRES harbor abnormalities related to autoimmunity, such as concurrent systemic lupus erythematosus. In this Review, we summarize the clinical and laboratory evidence that places PRES in the context of autoimmunity.     

PRSS2 regulates EMT and metastasis via MMP-9 in gastric cancer

Serine protease 2 (PRSS2) is upregulated in gastric cancer tissues, correlates with poor prognosis and promotes migration and invasion of gastric cancer cells. However, the exact mechanism by which PRSS2 promotes metastasis in gastric cancer is unclear. We examined serum PRSS2 levels in healthy controls and gastric cancer patients by enzyme linked immunosorbent assay (ELISA) and analyzed the correlation between PRSS2 serum level with the clinicopathological characteristics of gastric cancer patients and matrix metalloproteinase-9 (MMP-9) expression. A lentiviral MMP-9 overexpression vector was constructed and used to transfect gastric cancer cells with stable silencing of PRSS2, and migration, invasion and epithelial-mesenchymal transition (EMT) of gastric cancer cells were examined. High serum PRSS2 levels were detected in gastric cancer patients and associated with lymphatic metastasis and TNM stage. Serum PRSS2 was positively correlated with serum MMP-9 level. PRSS2 silencing inhibited EMT, and knock-down of PRSS2 partially abrogated cell metastasis and EMT caused by overexpression of MMP-9. These results suggest that PRSS2 promotes the migration and invasion of gastric cancer cells through EMT induction by MMP-9. Our findings suggest that PRSS2 may be a potential early diagnostic marker and therapeutic target of gastric cancer.     

通络开痹片治疗关节炎（类风湿关节炎、膝骨关节炎）疗效及安全性的真实世界研究

目的 评价真实世界中通络开痹片治疗关节炎［类风湿关节炎（rheumatoid arthritis,RA）、膝骨关节炎（knee osteoarthritis,KOA）］的效果及安全性,产生大样本量临床循证数据,为临床合理用药提供依据。方法 采取前瞻性研究方法,纳入12家中心2021—2022年收治的1001例RA及KOA患者,分为RA组和KOA组,均采用通络开痹片治疗,访视点是0、4、8、12周。随访并评估患者治疗12周的有效性［疼痛视觉模拟评分（visual analogue scale,VAS）、28个关节疾病活动性评分（disease activity score-28,DAS28）、健康评定问卷（health assessment questionnaire,HAQ）评分、中医症状评分、西安大略麦克马斯特大学（Western Ontario and McMaster University,WOMAC）骨关节炎指数评分等］及安全性。采用SAS9.4软件进行统计分析。结果 RA组基线时疼痛VAS评分为（5.09±1.70）分,治疗12周后下降至（2.75±1.51）分（P＜0.000 1）;DAS28评分基线为（4.97±1.31）分,治疗12周后下降至（3.55±1.12）分（P＜0.000 1）,提示治疗前大多数患者处于中高活动度,治疗后36.68%患者达到低疾病活动度和病情缓解;临床疾病活动性指数（clinical disease activity index,CDAI）评分基线为（22.45±13.35）分,表明82.03%的受试者处于中高度活动,治疗12周后CDAI评分降低至（10.82±7.87）分（P＜0.000 1）,表明57.29%的患者达到低度疾病活动度。KOA组基线时疼痛VAS评分为（5.14±1.64）分,治疗12周后降至（2.95±1.33）分（P＜0.000 1）;WOMAC评分基线为（63.44±33.91）分,治疗12周后降低至（35.21±21.77）分（P＜0.000 1）。两组的HAQ和中医症状评分均较基线改善,差异具有统计学意义（P＜0.000 1）。治疗期间发生的不良反应主要为神经系统不良发应（占比1%）,其次为消化系统（0.7%）、皮肤（0.6%）、肝胆（0.5%）、心血管（0.5%）及全身整体不良反应（0.5%）。结论 通络开痹片可有效降低RA、KOA患者的疼痛程度,不增加不良事件的发生率,值得临床推广。     

Cyanidin-3-rutinoside increases glucose uptake by activating the PI3K/Akt pathway in 3T3-L1 adipocytes

In this study, the effect of cyanidin-3-rutinoside (C3R) on glucose uptake by 3T3-L1 adipocytes was studied. C3R significantly increased glucose uptake, which was associated with enhanced plasma membrane glucose transporter type 4 (PM-GLUT4) expression in 3T3-L1 adipocytes. The potentiating effect of C3R on glucose uptake and PM-GLUT4 expression was related to enhanced phosphorylation of insulin receptor substrate 1 (IRS-1) and Akt, as well as augmented activation of phosphatidylinositol-3-kinase (PI3K) in the insulin signaling pathway. C3R induced glucose uptake was inhibited only by the PI3K inhibitor, but not by an AMPK inhibitor in 3T3-L1 adipocytes. Therefore, C3R likely up-regulates glucose uptake and PM-GLUT4 expression in 3T3-L1 adipocytes by activating the PI3K/Akt pathways.     

Clinical value of normal saline injection for expansion of the anterior perirectal space during prostate cryoablation

BackgroundThe objective of this study is to describe the technique and evaluate the clinical value of normal saline (NS) injection for expanding the anterior perirectal space during prostate cryoablation for prostate cancer (PCa) patients.MethodsPCa patients who received cryoablation between August 2014 and December 2019 were enrolled, and the technique of NS injection was adopted. The complications were evaluated. The prostate-specific antigen (PSA) nadir and biochemical progression-free survival (bPFS) were measured in localized PCa patients who received cryoablation as the primary treatment.ResultsA total of 159 PCa patients were included. Among 147 patients with the data of anterior perirectal space, the median (interquartile range [IQR]) distance of estimated iceball edge beyond the prostatic capsule was 8.3 (7.0–10.0) mm. No cases of urethrorectal fistula were reported; 29 patients developed urinary retention and 25 patients presented scrotal edema. All complications below Clavien-Dindo grade IIIb disappeared within 7 weeks after surgery. Urinary incontinence was reported in 6 patients. Among localized PCa patients, the median (IQR) follow-up time was 56.5 (36.0–73.5) months. The estimated 5-year bPFS was 82.3% overall, 82.8% for low-to intermediate-risk PCa patients, and 82.1% for high-risk PCa patients. For 52 patients received cryoablation alone, the median (IQR) PSA nadir was 0.147 (0.027–0.381) ng/mL.ConclusionsThe technique of NS injection for expanding the anterior perirectal space during cryoablation surgery could avoid urethrorectal fistula and might benefit localized PCa patients with lower PSA nadir and longer bPFS.     

C-反应蛋白/白蛋白与脓毒性休克患者90d预后价值的研究

目的:评估CRP/ALB比值在预测脓毒性休克患者90d死亡率中的作用。方法:收集在EICU入院的成人脓毒性休克患者共136例,按随访90d是否存活分为存活组与死亡组,记录两组患者基线特征、CRP、ALB数值,并计算CRP/ALB比值。采用统计学分析,确定各生物标记物对出院患者90d死亡率的诊断价值。结果:CRP dis及CRP/ALB dis较其他数据的AUC高,特异度亦较高,对出院后90d死亡有相对较好的诊断价值,二者比较差异有统计学意义,P=0.043。结论:CRP/ALB dis可作为脓毒性休克患者的长期预后指标。